Distance Counseling: Does it Really Work?

Distance Counseling: Can it really Work?

by

Theresa Holloway, LCPC

As our world continually moves into the technological realm of communicating, we find ourselves constantly needing to keep up the pace.  Distance counseling is becoming fast paced and more and more accepted as electronic processes become more sophisticated and comprehensive.

What is distance counseling?

Distance counseling is mental health counseling and all of its counterparts.  It takes traditional face-to-face counseling and transforms its delivery into electronic means that supports our growing dependence and need for technically assisted living.  Its method of delivery is via the telephone, secure e-mail, chat, video conferencing, and computerized stand alone software programs.

Does it work?

There are many studies that have been done to test the effectiveness of distance counseling.  Most of them indicate that distance counseling, regardless of the method, is as effective as face-to-face counseling.  In August of 2004 (American Counseling Association; Vol. 04-30) a study was completed that showed a significant decrease in depression for those participants who engaged in phone counseling for a period of 6 mo.  Another study to test the effect of distance counseling through structured writing, also indicated that depression and anxiety following a trauma where as effectively controlled and reduced by those participants who engaged in writing, either by mail or e-mail, as those who sought counseling face-to-face (Journal of Personal and Social Psychology; 9-06).   Women facing cervical cancer where given an opportunity to talk to a counselor by phone or to meet with a counselor face-to-face: many chose to talk to someone over the phone.  These women not only reported feeling satisfied with their counseling, but also experienced health benefits as well: faster healing, less anxiety, less depression, better eating habits, and better outlooks (University of California; Irvine; 4-08). 

I have personally engaged in distance counseling for many years and have found it to be as effective as my face-to-face counseling.  Though phone counseling is the most direct and similar to face-to-face and uses less actual time, e-mail offers a better chance to reflect on the client’s problem and formulate a more comprehensive and therapeutic plan.  I have not experienced chat room sessions or other methods, though I have been trained and simulated other methods, which seemed easy and effective to use as well. 

Authorization and payment for distance counseling is not accepted through all insurance companies; however, there is a movement toward universal acceptance of distance counseling as a professional and accredited method of delivery for mental health providers.

What are the advantages?

• Anonymity (there is a growing appreciation for the privacy distance counseling affords)
• Convenience (great flexibility in scheduling)
• Broader audience (reach more people: at greater distances)
• Less distraction (for writing or e-mail, less emotional distraction, time to gather thoughts

                                    and compose a comprehensive picture of the concern)

• Less or no travel
• Constant contact (the ability to keep in touch with face-to-face clients if leaving for an

                                     extended period of time)

What are the disadvantages?

• Some people want and need the traditional face-to-face counseling
• Though it is a growing phenomena, many people don’t understand or trust it
• Not all people have access to the technology required for some methods of delivery
• Counselors need to have good written communication skills
• Counselors need to be trained to listen where they can’t see (voice inflection, pauses, hesitations, volume increase or decrease in voice sound, speed of speech increase or decrease: and how to compensate, for instance, ask questions…”I noticed you hesitated…etc.)
• Counselors need to read between the lines with written communication (what punctuation is being used, what messages are repeated, what language is being used, how much content is actually there)
• Counselors need to be trained specially for distance counseling and receive certification
• Clients need to have good communication and writing skills (if not, the counselor has to work around this)

Distance counseling is becoming an increasingly attractive method for counseling.  With careful training and care to use it appropriately and professionally, there is no reason it could not be used as effectively as face-to-face counseling. 

Anyone wishing to get more information on distance counseling is welcome to e-mail me at tholloway@nperspectives.com.